Fernández Oliveira Carla, Martínez Roca Cristina, Ávila Álvarez Alejandro, Balboa Barreiro Vanesa, Giménez Arufe Víctor, Yáñez Gómez Pedro, Hermida Bouzas María Carmen, Martín Herranz Isabel
Servicio de Farmacia, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, A Coruña, España.
Servicio de Farmacia, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, A Coruña, España.
An Pediatr (Engl Ed). 2020 Aug;93(2):103-110. doi: 10.1016/j.anpedi.2019.12.018. Epub 2020 Feb 13.
There have been very few studies on the effect of assisted electronic prescription on paediatric patient safety. The objective of this study is to compare medication errors that occurred before and after its introduction in a tertiary hospital.
A quasi-experimental comparative study of medication errors detected before and after assisted electronic prescription introduction. All treatment lines were analysed in order to detect the point in the chain where the medication error occurred, as well as its type and cause. A Delphi study was conducted on the importance of each medication error involving doctors, nurses, and pharmacists.
The study included 166 patients (83 at each stage). At least one medication error was detected in 92% in the pre-introduction phase patients (2.8±2.1 errors/patient) and 7.2% of post-introduction phase patients (0.1±0.4 errors/patient). The assisted electronic prescription led to an absolute risk reduction of 40% (95% confidence interval=35.6-44.4%). The main cause of error was lapses and carelessness in both stages. Medication errors were considered serious in 9.5% of cases in the pre-introduction phase, while all of them were mild or moderate in the post-introduction phase.
The assisted electronic prescription implementation with prescription, validation and medication administration assistance systems significantly reduces medication errors and eliminates serious errors.
关于辅助电子处方对儿科患者安全影响的研究非常少。本研究的目的是比较在一家三级医院引入辅助电子处方前后发生的用药错误。
一项关于引入辅助电子处方前后检测到的用药错误的准实验性比较研究。对所有治疗流程进行分析,以确定用药错误发生在链条中的哪一点,以及其类型和原因。针对涉及医生、护士和药剂师的每种用药错误的重要性进行了德尔菲研究。
该研究纳入了166名患者(每个阶段83名)。在引入前阶段的患者中,92%检测到至少一处用药错误(每位患者2.8±2.1处错误),而在引入后阶段的患者中这一比例为7.2%(每位患者0.1±0.4处错误)。辅助电子处方使绝对风险降低了40%(95%置信区间=35.6-44.4%)。两个阶段错误的主要原因都是失误和粗心。在引入前阶段,9.5%的病例中的用药错误被认为是严重的,而在引入后阶段所有错误均为轻度或中度。
配备处方、验证和给药辅助系统的辅助电子处方的实施显著减少了用药错误并消除了严重错误。